Transitional Care for Type 1 Diabetes: The Certified Diabetes Educator Perspective
Bibliographic record
Abstract
Adolescence is a time when significant growth and development occur. Undergoing typical developmental transitions may include experiences such as academic pursuits, applying to post-secondary education, and striving for increased independence. Adolescents living with type 1 diabetes (T1D) will experience typical developmental tasks and manage an invisible life-threatening chronic disease that requires constant input and thoughtful choices in food, insulin dosing, and more. The transition of care from pediatric to adult diabetes clinics occurs during this fragile period in an adolescent’s life (Allen & Gregory, 2009; de Beaufort et al., 2010). Much research has involved adolescents undergoing transition, their families, and some healthcare provider (HCP) input. However, there is a notable lack of insight from registered nurses (RNs) working as certified diabetes educators (CDEs). RN CDEs are often highly trusted members of the diabetes team and have direct and extensive contact with patients, their families, and other HCPs. Using classic grounded theory methodology, a qualitative study was undertaken to understand the perspective of registered nurses working as certified diabetes educators on the transition of adolescents from pediatric to adult diabetes care programs. Seven CDE nurses from Calgary, Alberta were interviewed. Data analysis was completed using the constant comparative process, coding, and memo-writing. The core category and theory of Adaptation, with supporting categories of Loss, Embrace the New, and Red Tape emerged through analysis. Additionally, nurse participants discussed practical options for improving transitional care for adolescents, their families and healthcare providers in Calgary, Alberta.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.008 | 0.006 |
| Scholarly communication | 0.007 | 0.006 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.004 | 0.011 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".